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General NPI Number Information
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NPI Number | 1275357717
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Entity Type | Individual
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Provider Name | JULIAN A MCCALLA
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Gender | Female
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Dates
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Enumeration Date | 11/12/2024
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 6005 PARK AVE STE 500B
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City | MEMPHIS
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State | TN
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Zip | 38119-5215
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Country | US
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Telephone | 901-683-6925
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Fax | 901-684-1435
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Provider Business Mailing Address
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Address Line | 2169 COLERIDGE LN
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City | CORDOVA
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State | TN
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Zip | 38016-2617
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Country | US
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Telephone | 901-562-8221
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 37086
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License Number State | TN
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